PURCHASED REFERRED CARE CLERK

Fort Defiance Indian Hospital Board, Inc.; Northern (KY); Hybrid; USD 21,000 - 25,000; Full time

Job summary

Fort Defiance Indian Hospital Board, Inc. seeks a PRC Coordinator to initiate PRC applications, update the patient registration database, and route records to the Chief Medical Officer for medical priority.

You will educate patients on eligibility factors, process purchase orders or denials, maintain PRC files, and assist with transport requests and CHEF case submissions.

Qualifications

• High School Diploma or GED required.
• One year experience in registration, scheduling, screening, or customer service.
• Navajo Nation preference applies per policy.

Responsibilities

• Initiates PRC applications from patient information and family members.
• Updates the patient registration database with income, third party, and eligibility data.
• Routes PRC applications to the Chief Medical Officer for medical priority.
• Provides education to patients and providers on the PRC eligibility factors.
• Issues purchase orders or denials within specified time limits and maintains PRC files.
• Assists with emergent transport requests and CHEF case submissions as needed.

Skills

Customer service

Education

High School Diploma/GED

Job description

Fort Defiance
Fort Defiance, AZ 86504, USA

Description

Salary Range: $15.45 -$18.24/hour

**APPLICANT MUST HAVE A VALID, UNRESTRICTED INSURABLE DRIVERS LICENSE**

**RESUMES AND REFERENCES ARE REQUIRED**

ESSENTIAL DUTIES, FUNCTIONS AND RESPONSIBILITIES

• Initiates Purchased/Referred Care (PRC) applications from external providers by obtaining information from patient family members, or designated responsible person.
• Initiates PRC applications for FDIHB medical staff, nursing, and ancillary staff.
• Updates the patient’s registration database, including but not limited to income information, third party information, and any other information required to meet the eligibility factors of the PRC Program.
• Logs in all PRC applications/notifications by date of service.
• Routes all PRC applications/notifications to Chief Medical Officer (CMO) for medical priority.
• Provides education to patients and providers on the PRC five (5) eligibility factors.
• Issues purchase orders (PO) and/or denials are within specified time limits.
• Follows up with vendor for payment inquiry discrepancies, open documents and provides status on all PO's.
• Maintains PRC files according to current filing system.
• Assists with submitting and closing out Catastrophic Health Emergent Funds (CHEF) cases to assure reimbursement.
• Assists with Emergent transport requests from inpatient/outpatient departments by contacting ground and/or air medical transportation.
• Assists with received information for emergent transport companies and share information with receiving facility.
• Assists patients and providers with arranging non-emergent transports.
• Maintains transportation log for all medical transports.
• Provides information by telephone and personal inquiries regarding payment, outstanding charges eligibility, etc.
• Gathers information that are sensitive to PRC cases for eligibility, denials, appeals to submit to appropriate department.
• Enters all patient referrals into Referral Care Information System (RCIS) and ensures approval or denial is issued to patients and/or vendors.
• Performs other duties as assigned.

MANDATORY MINIMUM QUALIFICATIONS:

Experience:

One (1) year experience in registration, scheduling, screening, or customer service.

Education:

High School Diploma or Equivalency (HSE).

FDIHB and its facilities are located within the Navajo Nation and, in accordance with Navajo Nation law, has implemented a Navajo/Indian Preference in Employment Policy. Pursuant to this Policy, applicants who meet the minimum qualifications for this position and who are enrolled members of the Navajo Nation will be given primary preference in hiring and employment for this position and members of other federally recognized Indian tribes will be given secondary preference. Other candidates will be considered only after all candidates entitled to primary or secondary preference have been fully considered.

Qualifications

Education

Required

High School Diploma/GED or better.

Experience

Required

1 year:

One (1) year experience in registration, scheduling, screening, or customer service.

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.